Advantage Dental Group

NPI #1205276128 in Pueblo, Colorado

Provider Information

NPI Number: 1205276128
Entity Type: Organization
Organization Name: Advantage Dental Group
Primary Specialty: Dentist
Enumeration Date: Jun 25, 2013
Last Updated: Jun 25, 2013

Practice Location

Address: 1800 FORTINO BLVD UNIT 1
City: Pueblo
State: Colorado
ZIP Code: 81008-1891
Phone: (719) 545-1400

Authorized Official

Name: ERIC L. BERRY, DDS
Title: OWNER
Phone: (719) 545-1400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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